Scabies: Symptoms, Transmission, and Treatment

What is scabies?

Scabies is a contagious infestation of the superficial layers of the skin caused by the human scabies mite, Sarcoptes scabiei var. hominis. The most common symptom is intense itching, which may be more pronounced at night. The presence of similar symptoms in people who have been in close contact increases the likelihood of scabies.

What are the symptoms of scabies?

Itching that worsens especially at night.

Small red bumps

Scratches and scabs caused by scratching.

Thin tunnels

Itching in other people who have been in close contact

How is scabies transmitted?

Scabies is most commonly transmitted through close and prolonged skin contact. Sharing a bed, close family contact, or sexual contact are important routes of transmission. In classic scabies, transmission from objects is less important than direct skin contact; however, in crusted scabies, environmental transmission may be more significant.

How is scabies diagnosed?

Diagnosis can be made based on history and dermatological examination. Dermoscopy, skin scraping, and microscopic examination may be used if necessary. Visualization of mites, eggs, or fecal material under a microscope confirms the diagnosis. A negative test does not completely rule out classic scabies.

How is scabies treated?

Commonly used treatments include %5 permethrin cream and, in suitable patients, oral ivermectin. The choice of treatment depends on age, pregnancy status, concomitant diseases, and the extent of the disease.

Should people living in the same house also be treated?

It is important to evaluate close contacts during the same period. Infestation can also be found in people who do not yet have itching.

Why might itching persist after treatment?

Itching may persist for several weeks even after the mites have been removed. This is because the body develops an oversensitivity response to the mite and its remnants. The development of new tunnels or new rashes requires re-evaluation.

How should sheets, clothes, and towels be cleaned?

The Centers for Disease Control and Prevention (CDC) in the United States recommends washing recently used sheets, towels, and clothing in hot water and drying them in a hot dryer.

Applying temperatures above 50°C for at least 10 minutes can kill mites and their eggs. Items that cannot be washed can be kept in sealed bags for at least 72 hours, or up to about a week if necessary. Insecticides or fumigation of the house are not recommended for classic scabies.

What is crusted scabies?

Crusted scabies is a severe form that involves a very high mite load and is much more contagious than classic scabies. It is particularly common in immunocompromised individuals, the elderly, or those with certain neurological problems. Treatment usually involves a combination of topical and systemic therapies.

When should you consult a dermatologist?

If the diagnosis is uncertain

If more than one person in the same house has itching

If new tunnels develop despite treatment

If pregnant or breastfeeding

If it concerns a baby or young child

If the immune system is suppressed

If there are widespread crusted lesions

If a bacterial infection has developed

Frequently Asked Questions

Does scabies occur due to lack of cleanliness? No. Scabies is not an indicator of poor personal hygiene.

Does itching after treatment mean the treatment was unsuccessful? Not always. Itching can persist for several weeks even after successful treatment.

Is home fumigation necessary? Generally, no, for classic scabies. Insect sprays and fumigation are not recommended.

Dermatologist's Note

The success of scabies treatment depends on accurate diagnosis, correct medication administration, and simultaneous management of close contacts.